Early Childhood Development

Where do parents turn when they have concerns about their child’s development? From birth through the magical day when a child enters kindergarten, parents universally wonder if their child is developing normally and if there is something they should be doing to help their child.

These concerns are shared by the vast majority of parents and the accuracy of the answers to these questions depends on both the child’s age and the knowledge base of your child’s primary care providers. Many times, in an effort to make parents ‘feel better,’ they’ll be told: “Oh, there’s nothing wrong” or “He’ll grow out of it” or “Let’s wait and see how she develops in a year.” These words are meant to be reassuring but often are not the best advice.

When a parent is concerned, there is usually a reason. What a parent needs to know is that there are options available to address those concerns and they are available at no cost, and without regard to financial or legal status.

First, we must start with the understanding that the issue of child development falls largely in the educational realm of services, not into the medical model of care. What this means is that although a medical diagnosis might be involved, the evaluation procedures and educational programs of early childhood (birth through 5 years old) are regulated and run by the non-medical departments of city, county and state agency partnerships. What this means is that physicians can only suggest that a child receive early childhood evaluations or educational services and programs. The ultimate decision of whether or not to utilize services and programs, and whether they want to share that information with a child’s physician, is entirely up to the parents.

The first program that is made available to families who have concerns about their child’s development is called The Early Intervention Program, otherwise known as EI. The goal of early intervention is to identify areas of developmental delay and address them as early in a child’s life as possible, thus minimizing the delays that would otherwise exist when the child enters the school system. This program provides a wide variety of services including special education and occupational, speech and physical therapies for children from birth through 3 years old.

This program requires a multidisciplinary evaluation of the child’s development in order to determine eligibility and may include the participation of a developmental pediatrician and other medical diagnostic tests. This program is unique in its structure of placing the family as the “driver,” which means that the family is a full partner with all providers and plays a critical role as decision-maker and participant in the program. All services can be provided either in the child’s home, in an early intervention classroom or in other locations where the child spends his/her time (daycare center, etc.). It should be noted that all services provided under the Early Intervention Program are strictly confidential and, as such, are not part of a child’s ongoing school record.

The second program that is available to parents with concerns about early childhood development is the “Committee on Preschool Special Education” otherwise known as: “CPSE.” This program for children ages 3-5 is designed to either continue services that were started in the EI program through the “Transition” process, or to initiate services. Similar to qualification for early intervention, children must be evaluated by an interdisciplinary team for services and be determined to have a significant need. Parents continue to play a significant role in the process with the major difference being that CPSE is officially run by the local departments of education and/or school districts and all records of services become part of the child’s ongoing educational record. Services for CPSE are provided primarily in a Center-based classroom with an option for some home-based services when necessary.

Choosing the right program for your child requires a bit of legwork and a lot of discussion. Is the location of the program easy for you to get to when needed? Do you have a good rapport with the center’s administrator and teachers, does the school have a welcoming attitude and is information about your child listened to and heard? Is the teacher-to-child-ratio sufficient to provide your child with the necessary attention and if your child has a medical diagnosis, does the school have the necessary understanding and staff to address your child’s needs? Does the school have a clean and child-friendly environment? Is there adequate and safe outdoor space for your child to learn to explore his or her environment and interact with others outdoors? Investigate whether there are any special activities such as music and art to enhance the required services. If you have any concerns or the hairs on the back of your neck stand up, be sure to check the status of the school or center with the Bureau of Day Care to find out its licensure and safety record. Listen to your heart and act on it.

It is worthy to say that there is no one perfect school for everyone. You need to be comfortable and confident in the school or center you choose and stay in close contact with its administrators throughout the year in order to ensure that your child’s needs are addressed and that the services remain appropriate and adequate.

Recognizing potential problems in your child’s development is never easy. We all want to believe that our children will develop normally and that any problems we see will resolve themselves without intervention. However, the early detection and treatment of developmental issues has demonstrated very positive results for countless children. Our children need our persistence and follow-up on any concerns we have.